Chapter 32 The measurement of health-related quality of life for use in resource allocation decisions in health care

An important consideration when establishing priorities in health care is the likely effect that alternative allocations will have on the health-related quality of life (HRQoL) of the relevant population. This chapter considers some of the important issues surrounding the description and valuation of HRQoL. It discusses six main questions that need to be addressed when measuring HRQoL: What is to be valued?; How is it to be described?; How is it to be valued?; Who is to value it?; How are values for all health states to be generated?; and How are valuations to be aggregated? Since it is difficult to answer many of these questions on theoretical grounds alone, the chapter considers whether the existing empirical evidence can provide more definitive answers. Many important yet unresolved issues emerge and directions for future research are suggested. It is argued that this research agenda should have the gathering and analysis of qualitative data at its forefront.